Socioeconomic Status

Socioeconomic status plays a major role in the prevalence of depression and anxiety as well as the utilization of mental health services in the black female community. It is important to note that the four general indicators of SES are race/ethnicity, occupation, income and educational attainment; the latter is considered to be the predominant determinant of health in the United States. Aside from education, social scientists have analyzed other elements that explain the causal relationship between SES and the likelihood of developing mental disorders. For women of the black diaspora, neighborhood SES, negative self-perception and education are aspects of socioeconomic status linked to mental health outcomes.
Neighborhood status is a strong

indicator of an individual’s mental health, because the quality of one’s residential area reflects the physical, social and service environment. Watson and colleagues utilize neighborhood SES in order to examine the prevalence of depression and anxiety in black and white females (2012). The participants in this investigation are low-income women residing in Baltimore, Maryland. Regardless of race, women of low SES are prone to experience unstable relationships within the family, higher unemployment rates, financial struggles and poor health (Watson et al. 2012). Moreover, previous studies have concluded that African American women have lower and higher rates of depression and anxiety in comparison to their racial counterparts. This variability stems from a range of causes, from exposure to poverty to availability of social support. In fact, social support serves as one of the few protective effects against psychological and economic hardships. Results from the study demonstrate that women who reside in deprived neighborhoods have “fewer positive social interactions” throughout their everyday lives (Watson et al. 2012). Therefore, the beneficial effects of social support are diminished and these individuals become more at risk to depression and anxiety.
On a similar note, negative thinking is a mediator for depression because this mindset dictates self-perception and has the power to sustain depressive symptoms in individuals. For low-income, single mothers in the African American community, negative thought determines the effects of self-esteem, long-term stressors and quality of health on symptoms associated with depression (Hatcher et al. 2008). Specifically, self-esteem operates as another protective effect from this mental disorder, yet African-American women have to face a range of barriers to achieve self-acceptance. For example, colorism within the black community and negative images portrayed through various media outlets (which depict this group as either hypersexual beings or fit to only be domestic servants) provoke an inclination to internalize these perceptions as a norm (Hatcher et al. 2008). The detrimental impacts of racism and single-parenting promote this relationship between negative thinking and prevalence of depression and anxiety for black women of low SES.
As previously mentioned, educational attainment is a measure of socioeconomic status and a significant predictor of health outcomes throughout the lifespan.

According to Gazmararian and fellow social scientists, black women are two times as likely to suffer from depression than their white counterparts, regardless of SES (1995). In addition, this racial group is three times as likely to be low-income with less years of education. Notably, even though black women of low SES backgrounds share a higher risk of developing mental disorders, such as depression and anxiety, there is also a substantial concentration of risk present in high SES populations of the same racial identity (Gazmararian et al. 1995). An inverse relationship does exist between SES and prevalence of depression for black and white women, yet for females of the Black diaspora, the declining rates are not as pronounced as one achieves economic and educational success. Assimilation, care giving responsibilities and racism are three explanations for the predominance of depression in African-American females of high SES. (Gazmararian et al.

1995).
According to the Andersen and Newman’s sociobehavioral model, societal determinants is one of the three components that impact utilization of health services (Thurston & Phares 2008).

In other words, socioeconomic status serves as an impediment to seeking out clinical care for mental disorders. The mental health of low SES individuals is more negatively impacted with lack of utilization. Educational attainment, marital status, and accessibility of financial resources are the main factors that contribute to this disparity (Thurston & Phares 2008). Since many ethnic minorities tend to be of lower SES, they experience a higher likelihood of underutilization of mental health services. With that being said, the specific barriers that inhibit African-Americans from receiving medical attention for mental illnesses are as follows: accessibility, availability, acceptability and accountability (Thurston & Phares 2008). The first two obstacles stem from socioeconomic circumstances, while the remaining are facets of individual determinants. Accessibility refers to the cost of mental health services; availability indicates the number and quality of options that is economically feasible for an

individual.
In terms of service availability and accessibility, a majority of African-Americans depend on programs operating within the public sector (NAMI 2004). Moreover, safety net providers dictate the quantity and quality of mental health services. According to the National Alliance of Mental Illness, only ⅕ of the black population are insured through Medicaid, a public insurance program that finances treatment for low-income families (2004). Nevertheless, there is a mismatch in regards to the high concentration of African-Americans in deprived neighborhoods and lack of mental health professionals who accept Medicaid. Even though health insurance is offered through employment, black adults tend to work low-level jobs which offer few, if any, coverage plans (NAMI 2004). Individuals who fall under this category are not able to afford sufficient care, which represents a leading barrier to utilization. With that being said, the majority of African-American females are subjected to treat their mental illness through personal means; seeking out a physician who offers reasonably-priced services of great quality may induce more stress in this population.